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DePuy Hip Recall
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Chromium Poisoning Just as Dangerous as Cobalt Poisoning

December 17, 2010

Early this year, DePuy issued their recall for the ASR XL Acetabular System sold in the United States. Doctors began recommending revision surgery to those of their patients who reported pain or an overall failure of the DePuy hip implant. In many cases, the doctor was wise enough to run a blood test to determine whether there was excess metal in the bloodstream, as many medical studies have shown that elevated levels of metal are common for patients with metal-on-metal hip implants.

Patient after patient with the ASR Acetabular DePuy hip implant began turning up with cobalt and chromium levels that were well over 100 times normal.

Cobalt poisoning has been getting a great deal of attention and for good reason: the symptoms of cobalt poisoning include many serious side effects including neurological (brain) damage, heart irregularities, and seizures. Cobalt poisoning has also been linked to cancer. It's small wonder that many people, when they first learn that the DePuy hip implant leaks metal ions into the body, are primarily concerned about cobalt poisoning.

However, chromium poisoning is equally dangerous. And the symptoms are just as troubling.

Patients with elevated chromium levels show similar symptoms as those with elevated cobalt levels. There are notable differences; cobalt poisoning can cause cardiomyopathy, for example, while elevated chromium levels do not appear to cause heart problems but can cause problems with the reproductive system. The table below gives an overview of the symptoms shown by patients with elevated chromium levels vs. those with elevated cobalt levels.

If a particular type of chromium or cobalt has been specifically linked to a symptom, it is noted in parentheses next to the symptom. For example, mutated DNA is noted as being linked specifically to Chromium III.

Elevated Cobalt (Co) Levels

Elevated Chromium (Cr) Level

Genetic Information

  • Inability to repair DNA, reduce gene expression Co (II)
  • Can mutate DNA (Cr III)
  • Inability to repair DNA, reduced gene expression Cr (VI)

Localized tissue around the implant

  • Hypersensitivity
  • Inflammation
  • Infiltration of lymphocytes
  • Hypersensitivity
  • Inflammation
  • Infiltration of lymphocytes


  • Necrosis at high levels of Cr (VI)


  • Co excreted by the liver
  • Can impair liver function

Respiratory System

  • Asthma
  • Shortness of breath
  • Asthma
  • Shortness of breath

Nervous System

  • Oxidative Damage (Cr VI)

Heart and Vascular Systems

  • Possible cardiomyopathy

Endocrine System

  • Potential to alter the production of sex hormones Co (II)
  • Potential to induce hyothyroidism Co(II)
  • Potential to alter the production of sex hormones Cr (VI)

Visual and Auditory System

  • Loss of hearing
  • Vision Impairments
  • Loss of hearing
  • Vision Impairments

Reproductive System

  • Decreased sperm Cr (VI)
  • Abnormalities in sperm Cr (VI)
  • Reduced number of follicles Cr (VI)


  • May lead to an increased risk of cancer
  • May lead to an increased risk of cancer

What Does This Mean for My Health?

Chromium poisoning and cobalt poisoning are both very serious; however, there is no way to tell if you have either problem without getting a blood test to find out what your chromium and cobalt levels are. Even if you have elevated levels, you may still not have chromium or cobalt poisoning; slightly elevated levels are normal for patients who have metal-on-metal hip implants and among the doctors we've consulted, they do not consider slightly elevated levels to be cause for alarm.

Cobalt and chromium can both be retained in the bodily tissues for a long period of time, and if the body is subjected to excess levels, it will have a more difficult time processing the metal ions through the normal elimination process, especially if the kidneys are damaged - a problem sometimes caused by chromium poisoning. Little research has been done on the long-term effects of elevated metal ion concentrations.

When speaking to your doctor, we have a medical crib sheet that may be prove useful if you are uncertain what to ask about or worried you may forget important questions. We would also highly recommend you read this article on DePuy trying to get patients to agree to give the company access to their medical records; if you are thinking of pursuing a legal case against DePuy, signing away your medical records can be severely detrimental to your case.

If you have received a DePuy hip implant and are concerned about the effects chromium and cobalt poisoning may have on your health, please give us a call at 1-800-677-7095 or send us an email through our online system. We're here to answer your questions and help you build a case against DePuy if you think that is the best course of action for you. The health risks you've been asked to shoulder are immense and surely very upsetting; we will do our best to help in any way we can.

Contact Us

If you think you have a DePuy hip implant and would like to know more about the case, give our offices a call at 1-800-677-7095. Our people are standing by to answer your questions and explain how we can help.

DePuy Crib Sheets

Deciding what you want to do in the aftermath of this hip recall is extremely difficult. There are important medical and legal decisions to make, and you may not be feeling up to the task of figuring out the right questions to ask. We thought we'd try to make that a little easier for you.

Medical Crib Sheets
Legal Crib Sheets

Learn more about the DePuy Hip Recall Cheat Sheets or just go right ahead and download them - they're absolutely free and we hope they help during this difficult time.

DePuy Recall In The News

As new updates appear in the news on the DePuy hip recall and the ASR XL Acetabular System, we put those links up here so you can stay informed. If you'd like to be notified when we have news updates, please subscribe to our feed.

August 22, 2012
Johnson & Johnson Agrees to Pay About $200,000 Per Case to Settle Three ASR Lawsuits in Nevada

June 27, 2012
FDA Holds Hearing on Metal Hips But Dodges Fundamental Question of Inadequacy of Testing 

March 12, 2012
Too Little Too Late? Researchers Conclude Metal on Metal Hip Replacements Should Not Be Used.

»Read our complete archive of articles about the Depuy hip recall.

Have Questions?

We've got answers. We've compiled a list of the most frequently asked questions we receive from incoming clients and given you our most informed answers. We explain the lawsuit, why you don't need to spend any money to hire an attorney, and the risks to your health.

You can also browse our Stay Informed section for full articles on the case against DePuy and the medical problems with the ASR XL Acetabular total hip replacement system, or contact us directly.

View our FAQs on the DePuy hip recall.

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